Racial/Ethnic Disparities Across Indicators of Cigarette Smoking in the Era of Increased Tobacco Control, 1992–2019

Abstract Introduction This study compared tobacco use and cessation for African Americans (AA), Asians/Pacific Islanders (API), Hispanics/Latinos (H/L), American Indian/Alaskan Natives (AI/AN), and non-Hispanic Whites (NHW) in the United States to California (CA), the state with the longest continually funded tobacco control program. The purpose of this study was to identify tobacco use disparities across racial/ethnic groups across time. Methods Cigarette use prevalence (uptake and current use), consumption (mean number of cigarettes smoked per day [CPD]), and quit ratios were calculated across survey years, and trends were examined within each race/ethnic group and comparing between CA and the United States, utilizing the 1992–2019 Tobacco Use Supplements to the Current Population Survey. Results Prevalence decreased for all race/ethnic groups. Current use among CA NHW showed significant decline compared with US counterparts, whereas US H/L showed greater decline than CA counterparts. CPD decreased by approximately 30% across race/ethnic groups, with CA groups having lower numbers. The greatest decrease occurred among AA in CA (average 10.3 CPD [95% confidence interval (CI): 10.3, 12.6] in 1992/1993 to 3 CPD [95% CI: 2.4, 3.7] in 2018/2019). Quit ratios increased from 1992/1993 to 2018/2019 for CA H/L 52.4% (95% CI: 49.8, 53.0) to 59.3 (95% CI: 55.8, 62.5) and CA NHWs 61.5% (95% CI: 60.7, 61.9) to 63.8% (95% CI: 63.9, 66.9). Conclusions Although overall prevalence decreased over time for each racial/ethnic group, declines in CA outpaced the United States only for NHWs. Reductions in CPD were encouraging but the quit ratio points to the need to increase tobacco control efforts toward cessation. Implications The successes in reduced cigarette use uptake and prevalence across time for both California and the rest of the United States were observed largely among non-Hispanic White populations. Although reductions in the number of cigarettes smoked per day are a notable success, particularly among the Californian African Americans, efforts to support quitting across racial/ethnic groups, especially marginalized groups, need to be prioritized.

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Church-based interventions to address obesity among African Americans and Latinos in the United States: a systematic review

Nutrition Reviews ◽

10.1093/nutrit/nuz046 ◽

2019 ◽

Cited By ~ 3

Author(s):

Karen R Flórez ◽

Denise D Payán ◽

Kartika Palar ◽

Malcolm V Williams ◽

Bozena Katic ◽

...

Keyword(s):

United States ◽

Systematic Review ◽

African Americans ◽

Ethnic Disparities ◽

The United States ◽

Effect Sizes ◽

Community Based ◽

Vulnerable Communities ◽

Racial Ethnic ◽

The Church

Abstract Context Multilevel church-based interventions may help address racial/ethnic disparities in obesity in the United States since churches are often trusted institutions in vulnerable communities. These types of interventions affect at least two levels of socio-ecological influence which could mean an intervention that targets individual congregants as well as the congregation as a whole. However, the extent to which such interventions are developed using a collaborative partnership approach and are effective with diverse racial/ethnic populations is unclear, and these crucial features of well-designed community-based interventions. Objective The present systematic literature review of church-based interventions was conducted to assess their efficacy for addressing obesity across different racial/ethnic groups (eg, African Americans, Latinos). Data Sources and Extraction In total, 43 relevant articles were identified using systematic review methods developed by the Center for Disease Control and Prevention (CDC)’s Task Force on Community Preventive Services. The extent to which each intervention was developed using community-based participatory research principles, was tailored to the particular community in question, and involved the church in the study development and implementation were also assessed. Data Analysis Although 81% of the studies reported significant results for between- or within-group differences according to the study design, effect sizes were reported or could only be calculated in 56% of cases, and most were small. There was also a lack of diversity among samples (eg, few studies involved Latinos, men, young adults, or children), which limits knowledge about the ability of church-based interventions to reduce the burden of obesity more broadly among vulnerable communities of color. Further, few interventions were multilevel in nature, or incorporated strategies at the church or community level. Conclusions Church-based interventions to address obesity will have greater impact if they consider the diversity among populations burdened by this condition and develop programs that are tailored to these different populations (eg, men of color, Latinos). Programs could also benefit from employing multilevel approaches to move the field away from behavioral modifications at the individual level and into a more systems-based framework. However, effect sizes will likely remain small, especially since individuals only spend a limited amount of time in this particular setting.

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Trends in Cigar Use in the United States, 2002–2016: Diverging Trends by Race/Ethnicity

Nicotine & Tobacco Research ◽

10.1093/ntr/ntz060 ◽

2019 ◽

Vol 22 (4) ◽

pp. 583-587 ◽

Cited By ~ 1

Author(s):

Andrea H Weinberger ◽

Cristine D Delnevo ◽

Jiaqi Zhu ◽

Misato Gbedemah ◽

Joun Lee ◽

...

Keyword(s):

United States ◽

Black Women ◽

Ethnic Group ◽

Ethnic Groups ◽

Ethnic Differences ◽

Mixed Race ◽

The United States ◽

Race Ethnicity ◽

Racial Ethnic ◽

Over Time

Abstract Introduction Although there are racial/ethnic differences in cigarette use, little is known about how non-cigarette tobacco use differs among racial/ethnic groups. This study investigated trends in cigar use from 2002 to 2016, by racial/ethnic group, in nationally representative US data. Methods Data were drawn from the 2002–2016 National Survey on Drug Use and Health public use data files (total analytic sample n = 630 547 including 54 060 past-month cigar users). Linear time trends of past-month cigar use were examined by racial/ethnic group (Non-Hispanic [NH] White, NH Black, Hispanic, NH Other/Mixed Race/Ethnicity) using logistic regression models. Results In 2016, the prevalence of past-month cigar use was significantly higher among NH Black respondents than among other racial/ethnic groups (ps < .001). Cigar use was also higher among NH White respondents than among Hispanic and NH Other/Mixed Race/Ethnicity respondents. The year by racial/ethnic group interaction was significant (p < .001). Past-month cigar use decreased significantly from 2002 to 2016 among NH White and Hispanic respondents (ps = .001), whereas no change in prevalence was observed among NH Black (p = .779) and NH Other/Mixed Race/Ethnicity respondents (p = .152). Cigar use decreased for NH White men (p < .001) and did not change for NH White women (p = .884). Conversely, cigar use increased for NH Black women (p < .001) and did not change for NH Black men (p = .546). Conclusions Cigar use remains significantly more common among NH Black individuals in the United States and is not declining among NH Black and NH Other/Mixed Race/Ethnicity individuals over time, in contrast to declines among NH White and Hispanic individuals. Implications This study identified racial/ethnic differences in trends in past-month cigar use over 15 years among annual cross-sectional samples of US individuals. The highest prevalence of cigar use in 2016 was found among NH Black individuals. In addition, cigar use prevalence did not decline from 2002 to 2016 among NH Black and NH Other/Mixed Race/Ethnicity groups over time, in contrast to NH White and Hispanic groups. Further, cigar use increased over time for NH Black women. Targeted public health and clinical efforts may be needed to decrease the prevalence of cigar use, especially for NH Black individuals.

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Impact of Comorbidities on Racial/Ethnic Disparities in Hypertension in the United States

ISRN Public Health ◽

10.1155/2013/967518 ◽

2013 ◽

Vol 2013 ◽

pp. 1-8 ◽

Cited By ~ 5

Author(s):

Franklin Opara ◽

Kimberly Hawkins ◽

Aparna Sundaram ◽

Munira Merchant ◽

Sandra Rasmussen ◽

...

Keyword(s):

United States ◽

African Americans ◽

Odds Ratio ◽

Ethnic Disparities ◽

The United States ◽

Prevalence Odds Ratio ◽

Hypertension Prevalence ◽

Ethnic Variability ◽

Racial Ethnic ◽

Relevant Covariates

Background. Racial/ethnic disparities in hypertension (HTN) prevalence continue to persist in United States. We aimed in this study to examine the racial/ethnic disparities in hypertension prevalence and to determine whether or not health disparities may be explained by racial/ethnic disparities in co-morbidities. Materials and Methods. A cross-sectional design was used to examine the prevalence of hypertension among African Americans (AAs), Caucasians, and Hispanics in the National Health Interview Survey, 2003. The overall sample comprised 30, 852 adults. Results. There was a statistically significant racial/ethnic variability in hypertension prevalence, with AA/Blacks with the highest prevalence, χ2=393.0 (3), P<0.01. Hypertension was associated with co-morbidities, age, education, physical inactivity, marital status, income, sex, alcohol, and cigarette consumption, but not insurance. Relative to Caucasians, AAA/Blacks were 43% more likely while Hispanics were 40% less likely to report being diagnosed with high blood pressure, prevalence odds ratio (POR) = 1.43, 99% CI, 1.25–1.64, P=0.002, and POR = 0.60, 99% CI, 0.55–0.66, P<0.001, respectively. After adjustment for the relevant covariates including co-morbidities, racial/ethnic disparities in hypertension persisted; thus compared to Caucasians, African Americans were 61% more likely to be told by their health care providers that they were hypertensive, adjusted prevalence odds ratio (APOR) = 1.61, 99% CI, 1.39–1.86, P<0.001. In contrast, Hispanics were 27% less likely to be diagnosed with hypertension compared to Caucasians, APOR = 0.73, 99% CI, 0.68–0.79, P<0.001. Conclusions. There was racial/ethnic variability in hypertension prevalence in this large sample of non-institutionalized US residents, with the highest prevalence of hypertension observed among African Americans. These disparities were not removed after controlling for relevant covariates including co-morbidities.

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Differences in Diet Quality among Multiple US Racial/Ethnic Groups from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study and the Multi-Ethnic Study of Atherosclerosis (MESA)

Journal of Nutrition ◽

10.1093/jn/nxaa050 ◽

2020 ◽

Vol 150 (6) ◽

pp. 1509-1515 ◽

Cited By ~ 1

Author(s):

Luis A Rodriguez ◽

Yichen Jin ◽

Sameera A Talegawkar ◽

Marcia C de Oliveira Otto ◽

Namratha R Kandula ◽

...

Keyword(s):

United States ◽

African Americans ◽

Ethnic Groups ◽

South Asian ◽

Diet Quality ◽

South Asians ◽

Chinese Americans ◽

The United States ◽

Ethnic Study ◽

Racial Ethnic

ABSTRACT Background Diet quality is an important risk factor for type 2 diabetes (T2D) and cardiovascular disease (CVD). Little is known about the diet quality of South Asians in the United States, a group with higher rates of T2D and CVD compared with other racial/ethnic groups. Objective This study determined whether diet quality differs between South Asian adults in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study and whites, Chinese Americans, African Americans, and Hispanics in the Multi-Ethnic Study of Atherosclerosis (MESA). Methods Cross-sectional data from 3926 participants free of CVD from MESA visit 5 (2010–2011) and 889 South Asian participants from MASALA visit 1 (2010–2013) were pooled. Diet quality was assessed using the Alternative Healthy Eating Index (AHEI-2010) derived using FFQs. Multivariable linear regression models adjusted for age, sex, and total energy intake were used to compare mean differences in diet quality between the racial/ethnic groups. Results MESA participants were, on average, 14 y older than MASALA participants. The adjusted mean (95% CI) scores for the AHEI-2010 were 70.2 (69.5, 70.9) among South Asians, 66.2 (66.3, 68.2) among Chinese Americans, 61.1 (60.7, 61.6) among whites, 59.0 (58.4, 59.7) among Hispanics, and 57.5 (56.9, 58.1) among African Americans. The mean AHEI scores among South Asians were 3.1 (1.8, 4.3), 9.2 (8.3, 10.1), 11.2 (10.2, 12.3), and 12.8 (11.8, 13.7) points higher compared with Chinese Americans, whites, Hispanics, and African Americans, respectively. Conclusions South Asian adults in the United States have a higher diet quality compared with other racial/ethnic groups. This paradoxical finding is not consistent with the observed higher rates of T2D and CVD compared with other groups. This is further evidence of the importance of studying the South Asian population to better understand the causes of chronic disease not explained by diet quality.

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Racial/Ethnic Disparities in Receipt of Lung Transplant and In-Hospital Mortality among Pediatric and Adolescent Patients in the United States

International Journal of Translational Medical Research and Public Health ◽

10.21106/ijtmrph.335 ◽

2021 ◽

Vol 5 (2) ◽

pp. 68-71

Author(s):

Hamisu Salihu ◽

Brisa Garcia ◽

Deepa Dongarwar

Keyword(s):

United States ◽

Ethnic Groups ◽

Lung Transplant ◽

Healthcare Providers ◽

Ethnic Disparities ◽

The United States ◽

Inpatient Mortality ◽

Creative Commons ◽

Lung Transplants ◽

Racial Ethnic

The purpose of this study was to analyze racial/ethnic disparity in inpatient mortality among pediatric and adolescent lung transplant recipients (≤19 years old) in the United States (US). The Nationwide Inpatient Sample (NIS) dataset from 2003-2017 was used for this analysis. Survey logistic regression model was utilized to find the association between lung transplant and inpatient mortality among various racial/ethnic groups. The overall inpatient mortality rate was 3.92 per 100 lung transplant hospitalizations. Overall, when adjusted for covariates, those who received lung transplants were 8.49 times as likely to experience inpatient mortality (95% CI: 5.66-12.73) compared to those who did not receive it. The likelihood of inpatient mortality was highest among Hispanics (OR=10.11, 95% CI=4.93-14.95) relative to the findings among other racial/ethnic groups. Our findings may guide healthcare providers when caring for pediatric and adolescent populations from different racial/ethnic backgrounds who need a lung transplant. Copyright © 2021 Salihu, et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in this journal, is properly cited.

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The Association of Menthol Cigarette Use With Quit Attempts, Successful Cessation, and Intention to Quit Across Racial/Ethnic Groups in the United States

Nicotine & Tobacco Research ◽

10.1093/ntr/ntw215 ◽

2016 ◽

pp. ntw215 ◽

Cited By ~ 7

Author(s):

Courtney Keeler ◽

Wendy Max ◽

Valerie Yerger ◽

Tingting Yao ◽

Michael K. Ong ◽

...

Keyword(s):

United States ◽

Ethnic Groups ◽

The United States ◽

Intention To Quit ◽

Cigarette Use ◽

Menthol Cigarette ◽

Quit Attempts ◽

Racial Ethnic

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Tobacco use disparities by racial/ethnic groups: California compared to the United States

Preventive Medicine ◽

10.1016/j.ypmed.2016.08.035 ◽

2016 ◽

Vol 91 ◽

pp. 224-232 ◽

Cited By ~ 10

Author(s):

Kari-Lyn K. Sakuma ◽

Jamie Quibol Felicitas-Perkins ◽

Lyzette Blanco ◽

Pebbles Fagan ◽

Eliseo J. Pérez-Stable ◽

...

Keyword(s):

United States ◽

Ethnic Groups ◽

Tobacco Use ◽

The United States ◽

Racial Ethnic

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Racial and Ethnic Disparities in Years of Potential Life Lost Attributable to COVID-19 in the United States: An Analysis of 45 States and the District of Columbia

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18062921 ◽

2021 ◽

Vol 18 (6) ◽

pp. 2921

Author(s):

Jay J. Xu ◽

Jarvis T. Chen ◽

Thomas R. Belin ◽

Ronald S. Brookmeyer ◽

Marc A. Suchard ◽

...

Keyword(s):

United States ◽

District Of Columbia ◽

Ethnic Disparities ◽

The United States ◽

Attributable Mortality ◽

Race Ethnicity ◽

Using Data ◽

Rate Ratios ◽

Degree Of Association ◽

Racial Ethnic

The coronavirus disease 2019 (COVID-19) epidemic in the United States has disproportionately impacted communities of color across the country. Focusing on COVID-19-attributable mortality, we expand upon a national comparative analysis of years of potential life lost (YPLL) attributable to COVID-19 by race/ethnicity (Bassett et al., 2020), estimating percentages of total YPLL for non-Hispanic Whites, non-Hispanic Blacks, Hispanics, non-Hispanic Asians, and non-Hispanic American Indian or Alaska Natives, contrasting them with their respective percent population shares, as well as age-adjusted YPLL rate ratios—anchoring comparisons to non-Hispanic Whites—in each of 45 states and the District of Columbia using data from the National Center for Health Statistics as of 30 December 2020. Using a novel Monte Carlo simulation procedure to perform estimation, our results reveal substantial racial/ethnic disparities in COVID-19-attributable YPLL across states, with a prevailing pattern of non-Hispanic Blacks and Hispanics experiencing disproportionately high and non-Hispanic Whites experiencing disproportionately low COVID-19-attributable YPLL. Furthermore, estimated disparities are generally more pronounced when measuring mortality in terms of YPLL compared to death counts, reflecting the greater intensity of the disparities at younger ages. We also find substantial state-to-state variability in the magnitudes of the estimated racial/ethnic disparities, suggesting that they are driven in large part by social determinants of health whose degree of association with race/ethnicity varies by state.

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